Hyaluronidase-Facilitated High-Dose Subcutaneous IgG Effectively Controls Parvovirus B19 Infection in a Pediatric Cardiac Transplant Patient With Severe T-Cell Lymphopenia

Rachel J Cruz; Joseph F Dasso; Carla Duff; Diane Krasnopero; Zsofia Long; Maryssa Ellison; Daime Nieves; Panida Sriaroon; Alfred Asante-Korang; Jolan E Walter

doi:10.1093/ofid/ofaa076

Hyaluronidase-Facilitated High-Dose Subcutaneous IgG Effectively Controls Parvovirus B19 Infection in a Pediatric Cardiac Transplant Patient With Severe T-Cell Lymphopenia

Open Forum Infect Dis. 2020 Mar 12;7(5):ofaa076. doi: 10.1093/ofid/ofaa076. eCollection 2020 May.

Authors

Affiliations

¹ Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
² Department of Biology, University of Tampa, Tampa, Florida, USA.
³ Division of Cardiology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA.
⁴ Division of Allergy and Immunology, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA.
⁵ Massachusetts General Hospital for Children, Boston, Massachusetts, USA.

Abstract

We treated three pediatric cardiac transplant patients with chronic parvovirus viremia with high-dose intravenous immunoglobulin (HD-IVIG). One patient with severe T-cell lymphopenia suffered recurrent viremia and aseptic meningitis, which resolved remarkably when he was switched to high-dose hyaluronidase-facilitated subcutaneous immunoglobulin (HD-SCIG-Hy). We discuss the advantages of HD-SCIG-Hy vs HD-IVIG treatment for similar cases.

Keywords: heart transplant; immunodeficiency; parvovirus B19; pediatric; subcutaneous immunoglobulin.

Publication types

Case Reports